Salem Bible Church Forms

Campus*
Father's Name
First*
Last*
Mother's Name
First*
Last*
Child's Name*
Child's Name On Printed Certificate*
Date Of Birth*

Please Enter Month and Year Only (ex: 07/92)
Gender
Phone Number*
Address*
City*
State*
Zip*
Email*
(We will use to communicate confirmations and updates)
Baby Dedication Date: This date is NOT confirmed until you’ve attended the parent orientation.
Ministry Involvement
- Member
- Small Group
- Women's Ministry
- Men's Ministry
- Serving
Note: Dedication registration for those children/infants to 5 years.

Potential Volunteer’s Name*
Reference’s Name*
Reference Contact Number*
Please complete the following questions about the person that has listed you as a reference.
What is your relationship to the applicant?*
How long have you known the applicant?*
Do you have any concerns about this person working with children?*
Does this person work well with others? Will this person work well on a team?*
Does this person take guidance and criticism well?*
To the best of your knowledge, does this person have a relationship with Jesus Christ?*
Is there anything else you think we would need to know about this person?*
*
- By clicking this box, you agree that all information above is correct to the best of you knowledge.
*Required Fields

PRE - SETUP OPPORTUNITIES: WEDNESDAY, THURSDAY, AND FRIDAY